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The Storyteller: Jane Doe (Dr. Brian Day)Close

Fowler learned as a sophomore at the University of Pennsylvania that the United States was the only industrialized country without universal health care, and she decided then to dedicate her professional life to the work.

She first worked for Baucus from 2001 through 2005, playing a key role in negotiating the Medicare Part D prescription drug program. Feeling burned out, she left for the private sector but rejoined Baucus in 2008, sensing that a Democratic-controlled Congress would make progress on overhauling the health care system.

Baucus and Fowler spent a year putting the senator in a position to pursue reform, including holding hearings last summer and issuing a white paper in November. They deliberately avoided releasing legislation in order to send a signal of openness and avoid early attacks.

“People know when Liz is speaking, she is speaking for Baucus,” said Dean Rosen, the health policy adviser to former Senate Majority Leader Bill Frist (R-Tenn.).

The Money Cop: Earl Devaney

A former Secret Service agent, Devaney has very little to do with health care reform — directly, at least.

But as the guy tasked with minimizing fraud and waste in the $787 billion economic stimulus legislation, one of the single largest government expenditures in American history, Devaney is poised to influence the debate.

Here’s why: President Barack Obama and Democrats are proposing a health care fix that could exceed $1 trillion over 10 years — perhaps more, according to some estimates.

If Devaney finds egregious examples of wasteful spending on the stimulus front, his work could prove damaging to the president politically and may very well sour the public appetite for a government-heavy approach to health care.

It’s a bleed-over effect that has already been on display.

When the AIG bonuses erupted into a firestorm in mid-March, health care insiders viewed the development ominously. Obama’s approval ratings dipped to the lowest point of his presidency, and the public was outraged at the way the company, the administration and Congress bungled it.

The Storyteller: Jane Doe

Health care is about to enter the heart-tugging phase.

Groups on the right and left have been quietly building arsenals of narrators — people who can sear the American conscience with personal stories.

The American Cancer Society collects cases through a call center in Texas. The SEIU gathers stories by congressional district. And Conservatives for Patients’ Rights, an organization poised to oppose the Obama plan, sent a former CNN reporter to Britain and Canada to produce a documentary on outrages in the European system that critics claim the White House plan will mimic.

The last major health care reform effort in the 1990s was defined by Harry and Louise, the fictional middle-class couple featured in an insurance industry ad. And an extraordinarily complex bill went down amid a flurry of 30-second ads.

Given the fragmented media environment, a singular TV ad may not hold as much sway as it did in the early ’90s. But that doesn’t mean either side plans to pass up the tool.

Conservatives for Patients’ Rights was the first to use it, releasing a 60-second spot featuring Dr. Brian Day, a past president of the Canadian Medical Association, describing how patients in the country are “languishing and suffering on waiting lists.”

Expect to see Day lobbying members of Congress — and many more stories from both sides in the weeks to come.

The American people do not want to lose their right to choose care, doctor, treatment, medication and hospital. If government begins sticking its nose into the personal arena of who gets treatment when, and where, and even whether said person should get treatment, there will be serious cases going to court.

Only a miniscule segment of the population lacks health insurance. The vast majority of the American population has health care and coverage.

This begs the question: Who is actually clamoring loudest for universal health care? Could it be those who are paying for nothing right now, and who will continue to pay for nothing? In other words, those with the most to gain and the least to lose?

That's my guess. The other countries who are paying for universal coverage are in serious trouble. Rates keep going up and care keeps going down. Canada, Great Britain and France are three of the countries with "universal coverage" and systems that are in serious financial trouble.

If our government 1) can't even close the border with Mexico, allowing Americans to be unnecessarily exposed to a new flu virus, 2) has the audacity to swear in a woman as our HHS secretary when she openly admits that she supports abortion, even in the third trimester, and 3) has a president who is a smoker and drinker, what is the likelihood it will be able to manage a health care system for American patients?

I would say slim to nil. They need to butt out of our health care system, and let those who run it fix it.

America is ready and the time is right for a major Healthcare overhaul. You can not talk about the economy without talking about Healthcare , we need to fix Healthcare before we well ever see long term stability in the American economy.

The People want Healthcare and one way or another the America well get it.

as one who lives in canada, and who have accessed our health care several times, including surgeries for my mother, i can tell you that it is good. it is a comfort feeling that canadians take for granted.

there are always people who complain, and rightfully so. it is good to keep the system on tenterhooks, so that complacency is avoided. it is my belief, and every canadians' too, that the universal health care that we have, and which we pay through our taxes is a blessing that is much appreciated.

i think you also have your numbers wrong. i think there are more than 46 million u.s. citizens without healthcare. an american friend of mine, has colon cancer. his health care pays 80% of the total cost, which is $200,000. somehow or the other, he has to come up with $40,000. for most folks, this is big bucks.

living in canada, i am eternally grateful for our healthcare. we might have to wait for non emergency or elective surgery. but when needed, the urgency is immediately taken care.

The guy NOT to watch is Obama who has allready sold out to the insurance companies.

A Guy to watch is Conyers who has a true single payer system bill.

What we need in health care is:

A single payer system: One which uncouples employers from the burderns of heath care.

No Insurance component: With known morbidity and mortality rates for the last fifty years in the entire country, there is no room for a third party to take thirty five percent off the top. Pre-existing conditions and capital reserves are fictions for greedy insurance companies to avoid claims. If we know morbidity and mortality rates, there is no need for reserves above 2%, claim denial or third parties. Insurance companies exists to minimize and avoid risk. Health care is to guarantee the every illness is covered.

A private Industry run Payment adminstration like the TVA: Given the above, a private company created by Congress with a 7% capped overhead to distribute payments and fraud-check together with a Committee of the AMA. We do not need 21 year old clerks telling Doctors how to practice medicine.

Obama has the political capital and the votes to pass the Conyers bill, but his timid belief that Greedy Insurance Companies are "stakeholders" in health care is morally wrong and bad policy.

BTW: The AMA has endorsed my Plan as well as the major health consumer groups.

WE now pay more than 140% of what a good plan would cost and are 17th in the world in quality health care.

Because of our current sloppy system, the health care sysem we have is the third largest cause of death according to the AMA.

It's typical in the health care debate, that none of these people who are deemed the most influential in health care reform have any medical training and have no street knowledge of what it takes to deliver health care.

It's typical in the health care debate, that none of these people who are deemed the most influential in health care reform have any medical training and have no street knowledge of what it takes to deliver health care.

The American people do not want to lose their right to choose care, doctor, treatment, medication and hospital. If government begins sticking its nose into the personal arena of who gets treatment when, and where, and even whether said person should get treatment, there will be serious cases going to court.

Only a miniscule segment of the population lacks health insurance. The vast majority of the American population has health care and coverage.

This begs the question: Who is actually clamoring loudest for universal health care? Could it be those who are paying for nothing right now, and who will continue to pay for nothing? In other words, those with the most to gain and the least to lose?

That's my guess. The other countries who are paying for universal coverage are in serious trouble. Rates keep going up and care keeps going down. Canada, Great Britain and France are three of the countries with "universal coverage" and systems that are in serious financial trouble.

If our government 1) can't even close the border with Mexico, allowing Americans to be unnecessarily exposed to a new flu virus, 2) has the audacity to swear in a woman as our HHS secretary when she openly admits that she supports abortion, even in the third trimester, and 3) has a president who is a smoker and drinker, what is the likelihood it will be able to manage a health care system for American patients?

I would say slim to nil. They need to butt out of our health care system, and let those who run it fix it.

Spoken like a true know-nothing and a memebr of the party of "NO""...you're satisfied with the 17th rated health care system in the world that leads some thrid world nations in infant motality? Physician, PHUK yourself.

I'm trying to wrestle with the possibility to really follow the progress of the bill, HR 676. There will literally be a million stories on the largest change in Government to ever happen when this Health Care bill is implemented.

In the end, the wording and actual bill will be the only thing that counts before the final votes.

Thanks! A great public benefit to have this link available. I read it It is an article from the Cato institute that traces the history of how we got Medicare in 1965, and how it had been planned since the 1930's, together with Social Security. The article goes on to explain what tactics, thinking, and how they got Medicare passed as a bill in 1965, and makes the point that those same strategies and lies and "taking care of skeptics" ( with what we now might call "earmarks") were all a part of the plan.

The 4 paragraphs of conclusions are posted below. If you are a student of History, you will appreciate how a study of the past presage what may be forthcoming now (the "future."). It's not a USA today read (written at about the 4th grade level), but will be of some interest to some posters who like to absorb as many points of view about a specific issue as possible.

Conclusion

Congress members knew in 1965 that in passing Medicare they were legislating for all time to come. Political transaction costs had been molded to accomplish precisely that end. Senator Mundt (R., S.D.) regarded it as an "irreversible step" in that Medicare "would be exceedingly difficult to discontinue without breaking faith with those who have to pay the tax" (U.S. House Hearings 1963-64: 264). Senators and administration officials alike understood that they were "legislating in perpetuity" and would face strong pressures to expand the program (U.S. Senate Hearings 1965: 134). They also knew that Medicare would create a vast new public dependence on the federal government for financial security in old age, continuing the pattern set by Social Security in 1935. Senator Mundt (R., S.D.) described it as "another step toward destroying the independence and self-reliance in America which is the last best hope of individual freedom for all mankind" (U.S. Cong. Rec.-Senate 9 July 1965: 16122). Moreover, legislators knew that Medicare would take money from the poor and middle classes to subsidize the rich. Senator Gordon Allott (R., Colo.) described it to the Senate as a "program of 'Robin Hood in reverse'" that showed "complete disregard for need in disbursement" and represented a "giant step" toward making "every citizen as dependent as possible on his Government for his every need" (U.S. Cong. Rec.-Senate 8 July 1965: 15935).

But they also knew that Medicare would serve their political interests. As majority leader Rep. Carl B. Albert (D., Okla.) told his colleagues on the House floor, H.R. 6675 "is a bill which in my opinion will serve well those of us who support it, politically and otherwise, through the years" (U.S. Cong. Rec.-House 8 April 1965: 7435). Or, as Rep. Phillip Burton (D., Calif.) more crassly expressed it, "This bill is going to put into the pockets of my fellow Californians some $213 million its first year ... All in all our fair State and its people in the first year will be favored to the tune of some $550 million, a not modest sum" (U.S. Cong. Rec.-House 8 April 1965: 7429). Without doubt, the Social Security Amendments of 1965 were "so drafted that quite a bit of honey [had] been placed under the beehive in order to attract the bees" (U.S. Cong. Rec.-Senate 9 July 1965: 16071).

We have seen that political transaction-cost augmentation enabled government officials to embed Medicare in America's institutional structure at precisely the time when all the theoretical determinants of such behavior supported its pro-Medicare use for the first time in U.S. history. Indeed, the strategies most influential in passing and entrenching Medicare had as their goal and effect the manipulation of political transaction costs. By tying Medicare with a 7 percent increase in Social Security benefits, proceeding incrementally, narrowing the bill's coverage, misrepresenting its content, concealing its costs, and using countless other transaction-cost-increasing strategies described in this paper, government supporters of Medicare were able to achieve their objectives. These same tools, so instrumental in passing Medicare, today continue to serve those who seek further increases in federal control over U.S. health care. Their recent use in enacting previously reviled features of President Clinton's 1993 Health Security Act as part of the Health Insurance Portability and Accountability Act of 1996 warns anew of their potent ongoing role in the growing power of the federal government to control personal health care decisions (Twight 1997).

On the day the House of Representatives passed the Social Security Amendments of 1965, Rep. Hall (R., Mo.) spoke at length about the attempt being made under Medicare "to conceal the grant of power which would be extended to the Secretary of Health, Education, and Welfare to interfere with administration and medical practice in participating hospitals." Explaining why the federal government could not tell engineers and bookkeepers how to do their jobs, he remarked that "Men bred in freedom learn to like the taste of it" (U.S. Cong. Rec.-House 8 April 1965: 7392). From the perspective of many government officials who had pushed for decades to institutionalize Medicare, that was the point. In the future, fewer would learn to like the taste of it. So it has been. Americans' willingness in 1993 to seriously discuss a virtual government takeover of medical practice in the United States via President Clinton's 1,342-page Health Security Act attests to the long-run power of such changed institutions to reshape people's ideologies and thus the degree of government authority to which they acquiesce.